Acupuncture is a complex multi-component treatment that has shown promise for the treatment of Fibromyalgia (FM), however, clinical trials have shown mixed results, possibly due to heterogeneous methodology and lack of understanding of the underlying mechanism of action. We sought to understand the specific contribution of somatosensory afference to improvements in clinical pain, and the specific brain circuits involved.
76 FM patients were randomized to receive 8 weeks (2 treatments/week) of electroacupuncture (EA, with somatosensory afference) or mock laser acupuncture (ML, with no somatosensory afference). Brief Pain Inventory (BPI) Severity, resting state functional MRI (rs-fMRI), and proton magnetic resonance spectroscopy (H-MRS) in the right anterior insula (aINS) were collected at pre- and post-treatment.
FM patients receiving EA experienced a greater reduction in pain severity compared to ML (mean difference, EA=-1.14, ML=-0.46, Group x Time interaction, p=0.036). Participants receiving EA, as compared to ML, also displayed increased resting functional connectivity between the primary somatosensory cortical representation of the leg (S1; i.e. S1 subregion activated by EA) and aINS. Increase in S1-aINS connectivity was associated with reductions in BPI severity (r=-0.44, p=0.01) and increases in aINS gamma-aminobutyric acid (GABA+) (r=-0.48, p=0.046) following EA. Moreover, increases in aINS GABA+ was associated with reductions in BPI severity (r=-0.59, p=0.01). Finally, post-EA changes in aINS GABA+ mediated the relationship between changes in S1-aINS and BPI severity, bootstrapped CI=[-0.533, -0.037].
The somatosensory component of acupuncture modulates primary somatosensory functional connectivity in association with insular neurochemistry to reduce pain severity in FM.
The somatosensory component of acupuncture modulates primary somatosensory functional connectivity in association with insular neurochemistry to reduce pain severity in FM.To estimate the adjusted conditional overall survival (COS) in patients with esophageal cancer after receiving various treatment modalities via a national population-based database, and to investigate the possible time-dependent effects.
Eligible patients diagnosed with esophageal cancer between 2000 and 2016 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry. The Kaplan-Meier method was used to calculate conventional survival time. The inverse probability of treatment weighting method was used to estimate the adjusted COS in patients receiving different treatment modalities. Landmark analysis was employed to investigate the possible time-dependent effects of different treatment modalities in patients who had survived a certain period of time.
A total of 25,232 patients were included in the final analysis. https://www.selleckchem.com/products/mk-0159.html The conventional 5-year overall survival was 19.3%. The 5-year adjusted COS increased most for the first 3years, and increased slightly afterwards. In patients with r provided a dynamic view on optimization of treatment strategies.
The adjusted COS in patients with esophageal cancer increased as time accrued after receiving various treatment modalities. The time-dependent effects in specific tumor stage provided a dynamic view on optimization of treatment strategies.Left ventricular ejection fraction (LVEF) is considered an indicator of cardiac resynchronization therapy (CRT). Longitudinal studies on the predictive value of LVEF are scarce. We aimed to comprehensively evaluate the prognostic role of LVEF in the outcomes of Chinese patients with CRT.
Three hundred ninety-two patients were divided into three tertiles of LVEF ?25%, 25-30%, and 30-35%, and four groups by LVEF changes &lt;0% (negative response); ?0% and ?5% (non-response); &gt;5% and ?15% (response); and &gt;15% (super-response). One hundred six patients were super-responders. During a median follow-up of 3.6years, 141 reached the composite endpoint. Odds ratios (ORs) for super-response depicted a reversed U-shaped relationship for baseline LVEF with a peak at 25-30%. Independent predictors of super-response were smaller left atrial diameter [odds ratio 0.897, 95% confidence interval (CI) 0.844-0.955, P=0.001], smaller left ventricular end-diastolic diameter (OR 0.937, 95% CI 0.889-0.989, P=0.018), and hiognostic performance than LVEF tertiles at baseline, which should be considered when clinicians screening eligible patients for CRT.
Left ventricular ejection fraction of 25-30% is associated with a better prognosis of super-response. Predictors of super-response are different for LVEF tertiles. CRT responses would have better prognostic performance than LVEF tertiles at baseline, which should be considered when clinicians screening eligible patients for CRT.Photothermal agents with strong near infrared (NIR) optical absorbance and excellent biocompatibility and traceability are highly desired for precise photothermal therapy. This study reports the development of a dual-functional Fe3+ complex (Fe-ZDS) for imaging-guided, precise photothermal therapy of tumors. The complex has stable structure and obvious zwitterionic features, resulting in excellent biocompatibility and efficient renal clearance. The iron-dopa core structure renders the complex capable of generating magnetic resonance imaging (MRI) contrast, while synergistically exhibiting optical absorption in the red and NIR regions. Interestingly, the optical absorption of the complex is pH-sensitive, with significantly higher absorption intensity in a weakly acidic environment than in a neutral environment. Thus the complex can respond to acidic tumor stimuli and confine the energy of the laser to the tumor tissue. The MRI contrast and photoacoustic signal of the complex is taken advantage of to monitor the probe injection process and optimize the injection position and dosage for maximally covering the tumor tissue and assessing the activation of the complex in tumor tissues. The evolution of temperature inside the tissue during the laser irradiation is also monitored. Using Fe-ZDS as the theranostic probe, satisfactory treatment outcomes are achieved for photothermal therapy of tumors.